The use of electromyogram biofeedback to reduce Trendelenburg gait.

Ten subjects suffering from incomplete spinal cord injuries, clinically diagnosed as walking with Trendelenburg gait, underwent a 2 month therapy program to strengthen their muscles and reduce their gait abnormalities. Therapy involved muscle strengthening and gait training for 2 h a day, 5 days a week in a clinic. Biofeedback was also accomplished for 30 min each training day on all subjects. In addition, five of the subjects wore a two-channel electromyogram (EMG) biofeedback training device at home to see if neuromuscular re-education outside of the clinical setting could speed their recovery. The difference for these five subjects was that they would have continuous biofeedback therapy every time they walked and not biofeedback limited to only 30 min a day. Since weakness of the gluteus medius muscles is the prime contributor to Trendelenburg gait, the device provided warning tones giving feedback of improper gait through bilateral assessment of the use of the gluteus medius muscles. If too little gluteus medius activity was seen on the affected side or the step was too short in duration, the microprocessor provided an audio cue to the subjects alerting them to correct the deficit. Subjects only undergoing clinical therapy showed about a 50% reduction in hip drop due to therapy. However, the group that used the home training device showed almost normal gait after the 2 month period.